DESCRIPTION: (Applicant's Abstract) A 1992 survey conducted by the Educational Testing Service found that 47 percent of the United States population (90 million adults) demonstrate low literacy levels. These individuals are at greater risk for not obtaining necessary preventive and therapeutic health services and information. The proposed Breast Cancer Education Through Adult Literacy Programs (BCEALP) project is designed to reach members of this underserved population with breast cancer and early detection education. The BCEALP is a collaborative effort between the AMC Cancer Research Center and the Colorado Department of Education's Adult Education Office. By linking the objectives of a literacy program with those of a breast cancer education program, individuals who participate in the resulting BCEALP benefit in two ways: 1) they acquire reading and literacy skills which will help them to function more effectively in society; and 2) they obtain information and skills to improve their health status and that of their family members and close friends. The specific aims of the BCEALP are: develop an innovative educational program on breast cancer to be integrated into existing Adult Basic Education programs that have the potential of reaching over 500,000 persons within Colorado; pilot the program in ten Colorado Adult Basic Education programs; evaluate the BCEALP using both process and outcome measures; and initiate broader dissemination to adult literacy programs throughout Colorado and nationwide. The BCEALP is comprised of three modules based upon learner skills at three literacy levels as defined by the Colorado Department of Education. Each module will contain three units on different topics related to breast cancer: Unit I - Talking With Your Doctor; Unit 2 - Breast Cancer: What is it?; Unit 3 - Breast Cancer: What We Can Do About It! The pedagogical approaches directing the design of the program are participatory learning and problem-posing education. Learners will be given an active role in designing the program and in the learning process, consistent with the principles of adult learning. Each unit will consist of the utilization of a talk board which poses a problem for the learners to discuss with the instructor, audiotapes, and literacy skills- building exercises which reinforce key breast cancer messages being imparted during the unit. Classroom observation and learner interviews will provide process evaluation measures, and a telephone interview at three months post- program participation will provide outcome measures.